Gout intermittent period and how to treat the chronic stage

In the interim period and chronic phase of treatment, mainly to maintain the level of serum uric acid in the normal range and the prevention of acute attack. Colchicine prevention and treatment needed, in the recently symptomatic, that is, to 0.5-2 mg daily, often suffering from acute attack. In vivo and in vitro tests found that colchicine on the rapid cell growth inhibition, such as the gastrointestinal tract epithelial cells, hair cells, which could cause gastrointestinal discomfort and hair loss, it is not appropriate long-term use. In order to maintain normal serum uric acid, then with the promotion of uric acid excretion of uric acid formation and inhibit drug medicine, in order to guarantee effective dose should be adequate, and the maintenance of life. Application of uric acid lowering drug indications: ① diet control serum uric acid are still more than 416.5-476 micro-molar / liter (7-8 mg / l-); ② annually in the more than two acute; ③ a pain Wind stone or renal damage. That serum uric acid levels are maintained in the normal or near-normal levels, and often can prevent acute gout, gout stone formation and reduce kidney damage. The choice of drugs to reduce uric acid: in normal renal function or mild damage, and 24-hour urinary uric acid excretion in the following 600 mg, Pai uric acid drugs available in the middle of the above renal dysfunction (creatinine clearance rate of less than 35 ml / min), 24-hour urinary uric acid increased significantly application allopurinol alcohol; significantly increased serum uric acid and tophi deposition of a large number of patients, more than two drugs can be combined to prevent gouty with progressive disease. For the prevention of acute arthritis attack triggers, at the beginning, with a small amount in 7-10 days, gradually increase volume. (1) uric acid drugs row To prevent uric acid in the kidney caused from the large number of kidney damage and the side effects of kidney stones should be small doses, and to consider alkaline urine. ① probenecid (carboxymethyl benzene sulfonamides, Probenecid) 0.25 grams each, two times a day, to 0.5 grams after two weeks, three times a day, maximum daily dose of 2 g below. A rash, fever, gastrointestinal stimulation, renal colic, acute side effects such as excitation. ② Benghuanglong trazodone (Sulfinpyrazone)-Taisong derivatives. Pai role of uric acid than probenecid strong. Start of each 50 mg, twice daily, and gradually increased to 100 mg three times a day, the daily maximum amount of 600 mg. Probenecid combination with a synergy. Probenecid side effects than its small. Canker were cautiously uses. ③ Benzbromarone (Benzbromarone) trade names Narcaricin (Narcaricin) is stronger than the former two drugs to lower uric acid. Started each of 25 mg once a day, can be gradually increased to 100 mg. Minor side effects, gastrointestinal reactions, and there are very few rash, fever, acute renal colic attack and excited. No effect on the liver and kidney function. (2) inhibiting drugs uric acid production (currently only with allopurinol) Allopurinol alcohol (Allopurinol) in 1963, some anti-cancer drugs in the study, it was found that the tumor with allopurinol invalid, but gout effective, hematuria can be quickly lower the acidity, inhibition tophi and calculus formation, and promote pain Wind stone dissolution. Each 100 mg 2-3 times a day, lower than the daily maximum dose of 600 mg. Side effects are allergic rash, fever medicine, gastrointestinal discomfort and gastrointestinal bleeding, WBC and platelet reduction, such as liver damage. Therefore, in the course of treatment should be regularly checked leukocytes, platelets and liver function. Canker were cautiously uses. Gouty arthritis, only in acute attack taboo to heat and cold compress. Under normal circumstances, Diathermy, Iontophoresis therapy, infrared radiation, spas, mud therapy and other treatment methods such as massage and can be applied. When gout stones affect joint function or nerve compression, or with fistula drainage skin ulcer, it is necessary to remove sediment tremendous uric acid, in the weight-bearing joint pain or need fixed Under such circumstances, require surgical treatment.